Title
DOH Policy on Abortion Prevention and Management
Law
Doh Administrative Order No. 45b, S. 2000
Decision Date
May 2, 2000
The Department of Health's initiative aims to enhance the quality of healthcare services for women experiencing abortion and its complications by providing comprehensive prevention, treatment, and counseling, while ensuring accessibility across various healthcare facilities.
A

Goal

  • To improve quality healthcare services for prevention and management of abortion complications nationwide.

Objectives

  • Strengthen the healthcare system's capacity for abortion prevention and complication management.
  • Improve accessibility to quality post-abortion care for all women of reproductive age.

Coverage and Scope

  • Pilot implementation in 4 hospitals (2 DOH-retained, 1 LGU, 1 private) in year one.
  • Expansion to 50 DOH-retained hospitals by end of year five.
  • Activities include training, facility upgrades, service linkages, referral systems, supply availability, and provision of PMAC services.

Guidelines and Procedures

  • PMAC comprises three key elements: prevention/treatment, counseling, linkages to other RH services.

1. Prevention and Treatment

  • Early prenatal care to identify high-risk pregnancies to prevent abortion.
  • Patient education on vaginal bleeding and complications.
  • Coordination with blood donation programs.
  • Strict infection prevention protocols.
  • Decentralization of treatment services and standardization of care protocols.
  • Management includes assessment, evaluation, patient communication, timely referral, stabilization, uterine evacuation, and health education.
  • Community role emphasized in supporting patients and IEC campaigns to increase awareness.
  • Specific services defined per health care level from community to tertiary hospitals, including counseling, uterine evacuation, surgery, and blood transfusion.

2. Counseling

  • Provider training on communication and counseling.
  • Counseling addresses patient needs, procedure information, post-procedure care, warning signs, and family planning.
  • Emotional support includes addressing grief, guilt, and involving partners when appropriate.
  • Post-abortion family planning counseling is essential and should be initiated immediately.
  • Referral and follow-up mechanisms for patients undecided on contraception.

3. Linking PMAC with Other Reproductive Health Services

  • Integration with services for RTIs, STDs, cervical cancer screening, infertility counseling.
  • Identification and management of high-risk clients across RH facilities.

Implementing Mechanism

  • National level: Center for Family Health (CFH) responsible for policy, funding, and coordination.
  • Technical Working Group (TWG) established with government, professional, and academic representatives to formulate guidelines and action plans.
  • Regional level: CHDs monitor implementation and coordinate with hospitals.
  • Quality Assurance: PMAC aligns with Sentrong Sigla standards to maintain service quality.
  • Health facilities to establish networks linking PMAC with other RH services.

Effectivity

  • Order effective 15 days after publication.
  • Signed by Secretary of Health, May 2, 2000.

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